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Immunization rates have steadily improved over the last decade, in large part due to increased coverage of racial and ethnic minorities in state children's insurance programs. Nonetheless, nearly 1 in 4 young children in the United States are not appropriately immunized leaving them at risk of vaccine-preventable diseases.18 Thus, besides monetary barriers for families to immunization compliance, other significant impediments must exist.
In 2010, the Centers for Disease Control and Prevention's (CDC's) Task Force on Community Preventive Services updated their recommendations for interventions with the potential to improve immunization rates based on a literature review of their efficacy. The recommended interventions include: home visits to increase vaccination coverage; reducing client out-of-pocket costs; vaccination programs in schools and organized child care centers; vaccination programs in WIC settings; client/family incentive rewards; client reminder/recall systems; vaccination requirements for child care, school and college attendance; health care system-based interventions implemented in combination; immunization information systems; provider assessment and feedback; provider reminders; standing orders when used alone; and community-based interventions implemented in combination.
Previous research demonstrates the effectiveness of applying these best-practices recommendations in the ambulatory care setting. Nevertheless, there has not been wide-spread uptake of the CDC's immunization recommendations by healthcare practitioners likely due to a multitude of physician-level and systems-level barriers. The goals of this project are to improve practitioners' awareness of and adherence to immunization delivery best practices to improve early childhood immunization compliance rates.